<h3>Importance</h3> The high cost of cancer medicines is a public health challenge. Policy makers in the US and Europe are debating reforms to drug pricing that would cover both prices new when entering market price increases after they launched. <h3>Objective</h3> To assess launch prices, postlaunch changes, clinical benefit drugs compared with 3 European countries (England, Germany, Switzerland). <h3>Design, Setting, Participants</h3> This economic evaluation identified all were approved...

Potentially inappropriate medication (PIM) exposes patients to an increased risk of adverse outcomes. Many lists explicit criteria provide guidance on identifying PIM and recommend alternative prescribing, but the complexity available limits their applicability amount data prescribing.

Electronic medical records (EMRs) in general practice provide various methods for identifying patients with specific diagnoses. While several studies have focused on case identification via structured EMR components, diagnoses are frequently documented as unstructured free-text entries, making their use research challenging. Furthermore, may remain undocumented even when evidence of the underlying disease exists within data. This study aimed to quantify extent which contribute additional...

Background:Digitalization and patient empowerment result in new requirements challenges. In response, the module "Clinical Telemedicine/e-Health" was implemented by Faculty of Medicine Zurich 2008. The systematically evaluated to determine if students would benefit from this course. 2011, 2015, 2016 further evaluations were performed. Method:In 2008 2009, 16 statements. We calculated combined mean value medians for both evaluations. same evaluation conducted, results compared through U-test....

Sex differences in cardiovascular prevention have been reported, yet the role of sex with regard to different modifiable risk factors such as low-density lipoprotein cholesterol (LDL-C), systolic blood pressure (BP), and glycated hemoglobin (HbA1c) primary care settings is unclear. Therefore, we studied assessment measured values LDL-C, BP, HbA1c secondary delivered by general practitioners.This cross-sectional study was based on electronic medical records 59,092 patients (51.9% women) aged...

Abstract Aims To estimate the prevalence of chronic obstructive pulmonary disease (COPD) and related risk factors in people opioid agonist treatment (OAT), to compare airflow limitation severity age‐specific COPD rates with those general population, assess OAT patients’ willingness adopt life‐style changes use therapeutic offers for management. Design Cross‐sectional study a random sample patients. Setting Out‐patient centres substance addiction medicine Zurich, Switzerland. Participants A...

Abstract Background Medication safety in patients with polypharmacy at transitions of care is a focus the current Third WHO Global Patient Safety Challenge. review and communication between health professionals are key targets to reduce medication-related harm. Objective To study whether hospital discharge intervention combining medication enhanced information transfer primary physicians can delay readmission impact utilization or other health-related outcomes older inpatients polypharmacy....

Objectives: To provide a thorough assessment of the impact COVID-19 pandemic on utilization inpatient and outpatient mental healthcare in Switzerland. Methods: Retrospective cohort study using nationwide hospital data (n > 8 million) claims from large Swiss health insurer 1 2018-2020. Incidence proportions different types psychiatric admissions, consultations, psychotropic medication were analyzed interrupted time series models for general population vulnerable subgroup young people....

Purpose: The frequency of medication prescribing and polypharmacy has increased in recent years different settings, including Swiss general practice. We aimed to describe patient age- sex-specific rates prescriptions the most frequent classes, explore practitioner variability prescribing. Methods: Retrospective cross-sectional study based on anonymized electronic medical records data 111 811 adult patients presenting 116 practitioners 2019. used mixed-effects regression analyses assess...

Inappropriate medication and polypharmacy increase morbidity, hospitalisation rate, costs mortality in multimorbid patients. At hospital discharge of elderly patients, is often even more pronounced than at admission. However, the optimal strategy view sustained appropriateness remains unclear. In particular, unreflectingly switching back to pre-hospitalisation must be avoided. Therefore, both patients follow-up physicians should involved process. this study, we aim test whether a brief...

In randomised controlled trials with only few randomisation units, treatment allocation may be challenging if balanced distributions of many covariates or baseline outcome measures are desired across all groups. Both traditional approaches, stratified and by minimisation, have their own limitations. A third method for achieving balance consists randomly choosing from a preselected list sufficiently allocations. As this requires that heterogeneity between groups is measured specified...

BACKGROUND: Primary care databases collect electronic medical records with routine data from primary patients. The identification of chronic diseases in often integrates information various record components (EMR-Cs) used by providers. This study aimed to estimate the prevalence selected conditions using a large Swiss database and examine importance different EMR-Cs for case identification. METHODS: Cross-sectional 120,608 patients 128 general practitioners FIRE (“Family Medicine Research...

To study the implementation of a cluster randomised controlled effectiveness-implementation hybrid trial testing effectiveness medication review at hospital discharge combined with communication stimulus between physicians (HPs) and general practitioners (GPs) on rehospitalisation multimorbid older patients. Extension Grant's mixed method process evaluation framework to trials multilevel clustering. General internal medicine wards in Swiss hospitals. Convenience samples 15 chief (of 21...

Background Research on individual general practitioner (GP) workload, e.g. in terms of consultation counts, is scarce. Accurate measures are desirable because GPs' counts might be related to their work satisfaction and arguably, there a limit the number consultations GP can hold per day without jeopardizing quality care. Moreover, understanding association with characteristics crucial given current trends practice, such as increasing proportion female GPs, part-time group practices. Aim The...

Guidelines recommend initiation of statins depending on cardiovascular risk and low-density lipoprotein cholesterol (LDL-C) levels. In this retrospective cohort study, we aimed to assess guideline concordance statin treatment decisions find determinants undertreatment in Swiss primary care the period 2016–2019. We drew electronic medical records 8060 statin-naive patients (50.0% female, median age 59 years) with available LDL-C levels risk. Guideline was assessed based recommendations...

The severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) pandemic forced hospitals to redistribute resources for the treatment of patients with disease 2019 (COVID-19), yet impact on elective and emergency inpatient procedure volumes is unclear.We analyzed anonymized data 234 921 hospitalizations in 2017-2020 (55.9% elective) from a big Swiss health insurer. We used linear regression models predict, based pre-pandemic data, expected weekly numbers procedures 2020 absence compared...

Introduction Benzodiazepines and other sedative hypnotics (BSH) are potentially inappropriate harmful medications in older people due to their higher susceptibility for adverse drug events. BSH prescription rates constantly high among elderly patients even increase with age comorbidity. Deprescribing can be challenging both healthcare providers various reasons. Thus, physicians may benefit from a supportive tool facilitate deprescribing primary care consultations. This study intends explore...

Objective Patients with ‘late presentation’ (LP) of chronic hepatitis C infection (HCV) have already developed advanced liver disease before receiving direct-acting antiviral (DAA) treatment. Even after successful treatment, the risk morbidity and premature death remains elevated, leading to an unnecessary burden. This study aimed assess prevalence LP within prospective observational Swiss Hepatitis Cohort (SCCS) evaluate factors as determinants LP. Methods Treatment-naïve participants SCCS...

During the COVID-19 lockdown in spring 2020, Switzerland restricted non-urgent healthcare services to safeguard capacity. While prioritization of care was supposed be driven by medical urgency, demographic factors or economic incentives might have influenced hospitals' resource allocation decisions.

Background Chronic conditions are a significant public health concern due to their rising prevalence, association with high mortality, and substantial healthcare costs. General practitioners play crucial role in managing these conditions, quality indicators essential tools for assessing the of care. Electronic feedback reports incorporating indicator performance have shown promise improving care quality. However, most studies focused on single or link financial incentives, which may not...

AIMS OF THE STUDY: Arterial hypertension is a major global health risk. Global surveys indicate that only half of patients with arterial receive pharmacotherapy, and quarter achieve the primary blood pressure target recommended by guidelines. This study aimed to evaluate achievement in Swiss general practice, provide insights into treatment, identify factors associated achieving this goal. METHODS: cross-sectional utilised data from large care database. Patients hypertension, aged ≥18 years,...

Background: Since 1999, the University Hospital Zurich (Switzerland) offers an e-mail based online consultation where patients can ask doctors anonymous questions about individual health concerns. This study aimed at characterization of patient, content question and recommendations given specifically in field gastroenterology. Methods: In total, 3,489 inquiries were asked from July 2010 to December 2015. Based on International Classification Diseases ICD-10 Primary Care Code ICPC-2 252...

Tobacco abuse is a frequent issue in general practitioners' (GPs') offices, with doctors playing key role promoting smoking cessation to their patients. However, not all smokers are ready and willing give up smoking. Thus, GP focusing on alone might waste the opportunity improve his patient’s health by supporting change another harmful behaviour pattern. The aim of this study determine whether multi-thematic coaching will lead higher overall benefits without resulting reduced rate successful...

BACKGROUND To address low-value interventions in healthcare, “Choosing Wisely” campaigns provide recommendations of to avoid (RIAs). These are usually developed by expert panels rather than general practitioners (GPs). The aim our study was develop RIAs for ambulatory medicine based on the suggestions GPs, with their involvement from very beginning. METHODS This a nationwide online Delphi survey among Swiss Society General Internal Medicine members. In round one, each participant suggested...